Abstract
Since F. WUHRMANN presented the concept of myocardosis in 1 950, myocardial damage in various hepatic diseases have been reported. Recently, quantitative relationship between electrocardiographic changes and serum protein fraction or serum electrolytes in various hepatic, diseases have been studied. They show that abnormal electrocardiographic findings are closely related to dysproteinemia. Among them, according to T. Nangu in our department, the electrocardiographic changes in hepatic diseases have more important correlations to dyspro-teinemia than dyselectrolytemia. However, STY depression alone was reported not to relate with them. This study was designed to examine the 'coronary circulation and myocardial oxygen metabolism in patients with hepatic disease, and to clear the cause of STY deviation in them. Methods and Materials Two hundred and seventy cases with hepatic diseases were sub jected to the electrocardiographic examination. As hypoxemia test, the Levy's original method of ten percent oxygen inhalation for twenty minutes was used. The coronary circulation and myocardial metabolism at rest and during hypoxemia were studied in the patients with hepatic disease by the right-heart and coronary sinus catheterization. Results Obtained (1) Electrocardiogram at rest and induced hypoxemia test in hepatic diseases. 1 . Electrocardiographic changes related to myocardial damage such as T lowering (44.1 % ), IT prolongation (39.3 % ), STY depression (17.4]%) and low voltage (11.7%) were found in 65% of 230 cases, and these changes were more often seen in hepatic cirrhosis than in acute and chronic hepatitis. 2. Positive hypoxemia test occurred in 15 out of 56 cases with hepatic deseases. The rate of positive test was almost the same as in heart diseases or hypertension, and it was more often seen in chronic hepatic diseases than in acute patient. It is worth notice that in 5 out of 23 cases (21 .7 % ) the test was found positive who had no electrocardiogarphic sign of myocardial damage at rest. This is probably due to the presence of potential coronary vascular and/or myocardial metabolic disturbance in hepatic diseases. Therefore, the hypoxemia test is useful not only for the diagnosis of latent coronary disorders but of latent myocardial damages. (2) Hemodynamics and myocardial oxygen metabolism in patients with hepatic cirrhosis. 1 . The cardiac output was normal before and during hypoxemia. The cardiac work (Dexter) and the myocardial tension (Rodbard) were almost normal before and during hypoxemia.
